Evaluating an online consultation system in GP practices

Online consultations are potentially a way to improve patient access and to reduce GPs’ workload from face-to-face consultations. NHS England is promoting the use of online consultation systems in GP practices. However, the evidence on the use and effectiveness of online consultations is limited.

The researchers, in collaboration with the One Care Ltd, conducted the largest UK study of online consultations to date. The study examined the effectiveness, acceptability and impact of implementing a GP online consultation system (eConsult) in 36 GP practices in Bristol, South Gloucestershire and North Somerset.

Patients access the eConsult system via their GP practice website. Patients who want help for a specific condition are given options to access self-help information, learn about pharmacy treatments or contact NHS 111. Patients can also submit their symptoms via an online form, creating an ‘e-consultation’. For any urgent symptoms identified during the eConsult process, patients are signposted to their practice, emergency services or NHS 111.

The research found:

- Patient satisfaction with the online consultations was high and they improved access for some patients, but staff at GP practices didn’t think they created efficiencies
- 70% of online consultation resulted in a face-to-face or a telephone consultation with a GP
- Online consultations risk increasing workload in GP practices unless they are carefully implemented and effectively marketed
- Online consultations may have value for some patients, such as test results or advice for ongoing conditions, but they can’t replace face-to-face consultations in more complex situations
- Patients need guidance on when to use self-help, when to consult online, and when to book a face-to-face appointment
- Evaluating the implementation of online consultation systems is essential to monitor patient experience, risk and workload